St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
Unidad Nacional de Oncología Pediátrica, Francisco Marroquin University School of Medicine, Guatemala City, Guatemala.
Pediatr Blood Cancer. 2023 May;70(5):e30244. doi: 10.1002/pbc.30244. Epub 2023 Feb 14.
Quality cancer care depends on interdisciplinary communication. This study explored the communication practices of interdisciplinary clinicians, the types of healthcare services for which they engage in interdisciplinary collaboration, and the association between interdisciplinary care and perceived quality of care, as well as job satisfaction.
We conducted a survey of interdisciplinary clinicians from cancer centers in Guatemala, Honduras, Panama, El Salvador, and Haiti. The survey included 68 items including previously validated tools and novel questions.
Total 174 interdisciplinary clinicians completed the survey: nurses (n = 60), medical subspecialists (n = 35), oncologists (n = 22), psychosocial providers (n = 20), surgeons (n = 12), pathologists (n = 9), radiologists (n = 9), and radiation oncologists (n = 5). Oncologists reported daily communication with nurses (95%) and other oncologists (91%). While 90% of nurses reported daily communication with other nurses, only 66% reported daily communication with oncologists, and more than 50% of nurses reported never talking to pathologists, radiologists, radiation oncologists, or surgeons. Most clinicians described interdisciplinary establishment of cancer treatment goals and prognosis (84%), patient preferences (81%), and determination of first treatment modality (80%). Clinicians who described more interdisciplinary collaboration had higher job satisfaction (p = .04) and perceived a higher level of overall quality of care (p = .004).
Clinicians in these limited resource settings describe strong interdisciplinary collaboration contributing to higher job satisfaction and perceived quality of care. However, nurses in these settings reported more limited interdisciplinary communication and care. Additional studies are necessary to further define clinical roles on interdisciplinary care teams and their associations with patient outcomes.
高质量的癌症护理取决于跨学科的沟通。本研究探讨了跨学科临床医生的沟通实践、他们参与跨学科合作的医疗服务类型,以及跨学科护理与感知护理质量和工作满意度之间的关系。
我们对来自危地马拉、洪都拉斯、巴拿马、萨尔瓦多和海地的癌症中心的跨学科临床医生进行了调查。该调查包括 68 个项目,其中包括以前经过验证的工具和新问题。
共有 174 名跨学科临床医生完成了调查:护士(n=60)、医学专科医生(n=35)、肿瘤学家(n=22)、心理社会提供者(n=20)、外科医生(n=12)、病理学家(n=9)、放射科医生(n=9)和放射肿瘤学家(n=5)。肿瘤学家报告每天与护士(95%)和其他肿瘤学家(91%)进行沟通。虽然 90%的护士报告每天与其他护士进行沟通,但只有 66%的护士报告每天与肿瘤学家进行沟通,超过 50%的护士报告从未与病理学家、放射科医生、放射肿瘤学家或外科医生交谈过。大多数临床医生描述了跨学科制定癌症治疗目标和预后(84%)、患者偏好(81%)和确定初始治疗方式(80%)。描述更多跨学科合作的临床医生有更高的工作满意度(p=0.04)和更高的整体护理质量感知(p=0.004)。
在这些资源有限的环境中,临床医生描述了强有力的跨学科合作,这有助于提高工作满意度和感知的护理质量。然而,这些环境中的护士报告的跨学科沟通和护理更为有限。需要进一步研究以进一步确定跨学科护理团队中的临床角色及其与患者结局的关系。